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[Kato]

Im 57, on HRT since peri in 2017 and considered post menopause since 2018. Have built up to 4 pumps oestrogel and 200mg daily utregestan  which suited me very well. In a routine medicine check at my surgery the practice nurse advised reducing the utregestan to 100mg because that was my original prescription. A couple of weeks after doing that I started intermittent spotting/light bleeding. Got it checked by GP and referred to hospital for scan and hysteroscopy which showed 8mm uterus lining and small fibroid but Dr advised no action required other than to think about reducing HRT to 3 or 2 pumps and utregestan to 100mg - possibly 200mg if I manage 3 pumps to keep the balance right. By coincidence I  had routine smear test the week after which returned clear.
I’ve tried 3 weeks at 2 pumps and 100mg and feel awful. Bleeding also started again. Have increased to 3 pumps with 100mg but bleeding stopped then started again. I felt great on 4 pumps and 200mg utregestan with no bleeding. Is the thickened lining so dangerous or can I just carry on at the higher doses with my symptoms being managed well? Any advice appreciated. Thanks

[CLKD]

Ask immediately for a referral to a dedicated menopause clinic, there are waiting lists so getting a referral will get you into the 'queue' as it were.

If you have found 200mg works, then it isn't up to a Nurse to suggest that you reduce the dose.  Unless she is a Nurse Practitioner.  Even so, the GP should have been consulted.

Which Dr advised 'no action required', was it the Consultant who read the scan result or your GP?

I am sure that someone will be along with more info about lining measurements.  Browse round. 

Peri-menopause is those years leading up to our last monthly bleed = menopause proper.  No more.  Unless triggered by HRT.  It is usually suggested that 12 months since the last period mens that we may be in menopause, however: sometimes Nature has a final flurry as it were 

[Kato]

Thank you I will do that. The hospital Dr said no further action required although having said that, a biopsy was also taken as part of the procedure and I have not had results from that yet (but smear test was clear). The only route my GP could send me on to check out the post meno bleeding was the cancer route so I suspect the HRT/ menopause issues haven’t properly been considered and I’m feeling on my own again. I didn’t realise I could ask for referral to a menopause clinic so I will do that asap. 🙏 thank you

[sheila99]

It may be the fibroid causing the bleeding but you're at greater risk of cancer if it's thickened. Not sure how much risk but they panicked when mine was 6.7 and am being sent for a biopsy. You would be better on 200mg utro than 100. GP should prescribe under the circumstances but meno clinic if not. A mirena usually sorts out bleeding/thickened lining problems. If you don't mind a bleed you might consider sequi which may do a better job of shedding the lining.

[Kato]

Thanks shiela99 that’s very helpful. My only reservation about a mirena coil is that 17 years ago when suffering horrendous heavy bleeding I was fitted with a mirena coil but ‘lost it’ due to it being flushed out with the ongoing bleeding. I ended up having a microwave endometrial ablation (MEA) which sorted the bleeding out. The recent scan and hysteroscopy showed scarring from that MEA to the extent that they struggled to get access to accurately measure the lining. I’m wondering if it’s time to check out a mirena coil again. I’ll definitely try and get a GP appointment to look at options. Thanks again

[Nas]

Chelsea and Westminster hospital state on their website that 200 utrogestan can be taken daily to control bleeding.

I would be inclined to ask the GP to prescribe the 200 daily and request that you are scanned 3/6 monthly to check the lining?

‘If it ain’t broke don’t fix it’.

You were doing so well and that nurse has upset a perfectly good regime.

[Kato]

Thanks so much Nas that’s very reassuring. As you say, it was all going fine and I’m just going to concentrate on getting that equilibrium back 😃🤞

[Nas]

Good luck.
Some women need double utrogestan to keep bleeds at bay, simple.
If you tolerate it well, carry on I say.
Chelsea and Westminster state this clearly and Nick Panay who headed up the clinic there initially, is far more knowledgeable and outside the box thinking, than said nurse at local practice !